The evidence surrounding the use of Vitamin K antagonists (VKAs) in the context of cardiovascular disease, particularly atrial fibrillation, highlights some efficacy but also significant risks. A study involving 1,350 patients demonstrated that VKAs produced a low annual incidence of thromboembolic events and cardiovascular death (4.4%), but it revealed more risk factors than substantial benefits, indicating that while VKAs are an option, they might not be the best choice for all patients due to their limitations [2]. Furthermore, an analysis showed that VKAs may be associated with higher overall mortality compared to direct oral anticoagulants (DOACs), suggesting a need for caution in their use [4].
On the other hand, while VKAs showed effectiveness in resolving left ventricular thrombosis in a subset of patients, complications such as strokes and major bleeding, although low, did remain a concern [1]. Additionally, patients with better kidney function experienced improved outcomes with non-vitamin K antagonist oral anticoagulants, which may indicate a growing preference for these alternatives over VKAs in managing atrial fibrillation, especially considering their safety profile [3]. Overall, while VKAs are recognized in certain cardiovascular treatments, their risks and comparative efficacy suggest that other options might often be favored.